Dupuytrens Corrective Surgery-it's Not So Difficult

Dupuytrens contracture: Corrective surgery. A condition whereby the subcutaneous fascia contracts and causes irreversible deformity of the digits. This makes it hard for patients to properly use their hands and to put their hand flat on a table. Here amputation was considered for the little finger as the deformity was so severe but the patient asked me to try to straighten and save the digit. Case 1: 47yo male Pre-Operative: Marked deformity of the little (> 45 degrees at the PIP jnt) and ring fingers.

Intra-operative: Subtotal fasciectomy with careful dissection of the cords and bands.

Post-operative: Correction of deformity.

At 2 months; hand/fingers able to lie flat on table Case 2: 47 yo male, stiff long finger

Contracture PIP jnt of approx. 45

Cord along radial border of PIP jnt. Dissect carefully, beware nearby neuro vascular structures. Also perform capsulotomy of PIP jnt.

Corrected. Straight. Case 3:

61 yo,M, worker. Bilateral. Dominant right hand. When PIP deformity > 90, best to amputate digit. Left hand, previous surgery, PIP > 90, also amputate little finger.

Patient requested amputation of little finger( and correction of ring finger).

Amputate at neck/mid shaft level and contour. Often, other people never notice the hand with only 3 digits.

At 2 mths. copyright 2007 eugene [sic]